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Pathogenesis, immunology, and immune-targeted management of the multisystem inflammatory syndrome in children (MIS-C) or pediatric inflammatory multisystem syndrome (PIMS): EAACI Position Paper.
Pediatr. Allergy Immunol. 34:e13900 (2023)
Multisystem inflammatory syndrome in children (MIS-C) is a rare, but severe complication of coronavirus disease 2019 (COVID-19). It develops approximately 4 weeks after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and involves hyperinflammation with multisystem injury, commonly progressing to shock. The exact pathomechanism of MIS-C is not known, but immunological dysregulation leading to cytokine storm plays a central role. In response to the emergence of MIS-C, the European Academy of Allergy and Clinical Immunology (EAACI) established a task force (TF) within the Immunology Section in May 2021. With the use of an online Delphi process, TF formulated clinical statements regarding immunological background of MIS-C, diagnosis, treatment, follow-up, and the role of COVID-19 vaccinations. MIS-C case definition is broad, and diagnosis is made based on clinical presentation. The immunological mechanism leading to MIS-C is unclear and depends on activating multiple pathways leading to hyperinflammation. Current management of MIS-C relies on supportive care in combination with immunosuppressive and/or immunomodulatory agents. The most frequently used agents are systemic steroids and intravenous immunoglobulin. Despite good overall short-term outcome, MIS-C patients should be followed-up at regular intervals after discharge, focusing on cardiac disease, organ damage, and inflammatory activity. COVID-19 vaccination is a safe and effective measure to prevent MIS-C. In anticipation of further research, we propose a convenient and clinically practical algorithm for managing MIS-C developed by the Immunology Section of the EAACI.
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Publikationstyp
Artikel: Journalartikel
Dokumenttyp
Review
Schlagwörter
Delphi ; Mis-c ; Sars-cov-2 ; Children ; Clinical Algorithm ; Clinical Guidance ; Hyperinflammation ; Intravenous Immunoglobulin ; Management ; Steroids; Bronchial Epithelium; Kawasaki-disease; United-states; Dysregulation; December; Usa
ISSN (print) / ISBN
0905-6157
e-ISSN
1399-3038
Zeitschrift
Pediatric Allergy and Immunology
Quellenangaben
Band: 34,
Heft: 1,
Artikelnummer: e13900
Verlag
Wiley
Verlagsort
111 River St, Hoboken 07030-5774, Nj Usa
Nichtpatentliteratur
Publikationen
Begutachtungsstatus
Peer reviewed
Institut(e)
Institute for Allergy Research (IAF)